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Mayer M, Thoelken R, Jering M, Märkl B, Agaimy A, Zenk J. Pleomorphic adenoma of the parotid gland presenting as extensively ossified lesion with bone infiltration: a case report. Braz J Otorhinolaryngol 2022; 88 Suppl 4:S215-S218. [PMID: 34794917 DOI: 10.1016/j.bjorl.2021.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/29/2021] [Accepted: 07/19/2021] [Indexed: 12/14/2022] Open
Affiliation(s)
- Marcel Mayer
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Augsburg, Germany.
| | - Ruben Thoelken
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Augsburg, Germany
| | - Monika Jering
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Augsburg, Germany
| | - Bruno Märkl
- Institute of Pathology and Molecular Diagnostics, University Hospital Augsburg, Germany
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen, Germany
| | - Johannes Zenk
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Augsburg, Germany
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Jering M, Mayer M, Thölken R, Schiele S, Müller G, Zenk J. Cancer-specific and overall survival of patients with primary and metastatic malignancies of the parotid gland - A retrospective study. J Craniomaxillofac Surg 2022; 50:456-461. [DOI: 10.1016/j.jcms.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/14/2022] [Accepted: 03/01/2022] [Indexed: 10/18/2022] Open
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Mayer M, Zellmer S, Zenk J, Arens C, Ebigbo A, Muzalyova A, Thoelken R, Jering M, Kahn M, Breitling LP, Messmann H, Deitmer T, Junge-Hülsing B, Römmele C. Status quo after one year of COVID-19 pandemic in otolaryngological hospital-based departments and private practices in Germany. Eur Arch Otorhinolaryngol 2022; 279:1063-1070. [PMID: 34297182 PMCID: PMC8298954 DOI: 10.1007/s00405-021-06992-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/09/2021] [Indexed: 01/02/2023]
Abstract
PURPOSE The COVID-19 pandemic has affected healthcare systems worldwide. Data on the impact on otolaryngological clinics and private practices is sparse. This study aimed to present data on healthcare worker (HCW) screening, status of HCW, pre-interventional testing, the use of personal protective equipment (PPE) and the economic impact of the pandemic. METHODS Otolaryngological private practices and hospital-based departments were surveyed nationwide using an online questionnaire. Participating facilities were recruited via the German Society for Oto-Rhino-Laryngology and the German Association for Otolaryngologists in Bavaria. RESULTS 365 private practices (2776 employees) and 65 hospitals (2333 employees) were included. Significantly more hospitals (68.7%) than practices (40.5%) performed pre-interventional testing in their outpatients (p < 0.00). Most inpatients were tested in practices and hospitals (100.0% and 95.0%; p = 0.08). HCW screening was performed in 73.7% of practices and in 77.3% of hospitals (p = 0.54). Significantly more HCW infections were reported in private practices (4.7%) than in hospital (3.6%; p = 0.03). The private or home environment was the most frequent source of infection among HCW in hospitals (44%) and practices (63%). The use of PPE increased over the course of the pandemic. The number of procedures and the revenue decreased in 2020. CONCLUSION The rate of pre-interventional testing among outpatients in otolaryngological practices is low and HCW infections were found to be more frequent in practices than in hospitals. In addition, a high rate of infections in otolaryngological HCW seems to stem from the private or home environment.
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Affiliation(s)
- Marcel Mayer
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Augsburg, Sauerbruchstraße. 6, 86179, Augsburg, Germany.
| | - S Zellmer
- Department for Internal Medicine III-Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - J Zenk
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Augsburg, Sauerbruchstraße. 6, 86179, Augsburg, Germany
| | - C Arens
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Magdeburg, Leipziger Straße 44. 6, 39120, Magdeburg, Germany
| | - A Ebigbo
- Department for Internal Medicine III-Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - A Muzalyova
- Department for Internal Medicine III-Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - R Thoelken
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Augsburg, Sauerbruchstraße. 6, 86179, Augsburg, Germany
| | - M Jering
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Augsburg, Sauerbruchstraße. 6, 86179, Augsburg, Germany
| | - M Kahn
- Department for Internal Medicine III-Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - L P Breitling
- Department for Internal Medicine III-Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - H Messmann
- Department for Internal Medicine III-Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - T Deitmer
- German Society for Oto-Rhino-Laryngology, Head and Neck Surgery, Friedrich-Wilhelm Straße 2, 53113, Bonn, Germany
| | - B Junge-Hülsing
- Practice for Otolaryngology, Josef-Jägerhuber-Straße 7, 82319, Starnberg, Germany
| | - C Römmele
- Department for Internal Medicine III-Gastroenterology and Infectious Diseases, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
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Jering M, Mayer M, Thölken R, Schiele S, Maccagno A, Zenk J. Diagnostic Accuracy and Post-Procedural Complications Associated with Ultrasound-Guided Core Needle Biopsy in the Preoperative Evaluation of Parotid Tumors. Head Neck Pathol 2021; 16:651-656. [PMID: 34919166 PMCID: PMC9424419 DOI: 10.1007/s12105-021-01401-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/01/2021] [Indexed: 11/08/2022]
Abstract
Correct diagnosis of a parotid neoplasm based on histology preoperatively is of utmost importance in order to guide patient management. The aim of this study was to evaluate the diagnostic accuracy of an ultrasound-guided core needle biopsy of a parotid lesion and to describe associated post-procedural complications. A retrospective study was conducted between January 2015 and March 2021 of all patients who were referred to a tertiary care center for evaluation of a parotid lesion and who underwent core needle biopsy due to high-risk features or when malignancy was suspected on clinical examination or ultrasonography. Patient characteristics, histological findings, and post-procedural complications were recorded and evaluated. Among 890 patients referred for evaluation of a parotid lesion, in 138 patients a core needle biopsy was undertaken. On the basis of core needle biopsy findings, 11 lymphomas and 82 non-lymphoma malignancies were diagnosed in the parotid gland. The sensitivity of the core needle biopsy predicting the accurate tumor type was 97.56% (95% CI 91.47-99.70%) and the specificity 94.64% (95% CI 85.13-98.88%). The accuracy for the correct histopathological diagnosis was 93.48% (95% CI 87.98-96.97%). Post-procedural minor complications occurred in 19 patients (13.8%). In conclusion, a core needle biopsy can identify malignancy in the parotid gland with high sensitivity and specificity in a safe manner and therefore guide surgical treatment.
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Affiliation(s)
- Monika Jering
- grid.7307.30000 0001 2108 9006Department of Otolaryngology, Head and Neck Surgery, Medical Faculty, University Hospital Augsburg, University of Augsburg, Sauerbruchstaße 6, 86156 Augsburg, Germany
| | - Marcel Mayer
- grid.6190.e0000 0000 8580 3777Department of Otolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Kerpener Straße 62, 50931 Cologne, Germany
| | - Rubens Thölken
- grid.7307.30000 0001 2108 9006Department of Otolaryngology, Head and Neck Surgery, Medical Faculty, University Hospital Augsburg, University of Augsburg, Sauerbruchstaße 6, 86156 Augsburg, Germany
| | - Stefan Schiele
- grid.7307.30000 0001 2108 9006Institute of Mathematics, University of Augsburg, Universitätsstraße 2, 86159 Augsburg, Germany
| | - Andrea Maccagno
- grid.7307.30000 0001 2108 9006Institute of General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany
| | - Johannes Zenk
- grid.7307.30000 0001 2108 9006Department of Otolaryngology, Head and Neck Surgery, Medical Faculty, University Hospital Augsburg, University of Augsburg, Sauerbruchstaße 6, 86156 Augsburg, Germany
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Thölken R, Jering M, Mayer M, Schiele S, Müller G, Zenk J. Prospective study on complications using different techniques for parotidectomy for benign tumors. Laryngoscope Investig Otolaryngol 2021; 6:1367-1375. [PMID: 34938876 PMCID: PMC8665421 DOI: 10.1002/lio2.694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/06/2021] [Accepted: 10/25/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Long-term prospective studies on procedure-related complications after parotid surgery for benign neoplasms (BNs) are scarce. This is the first prospective study on the use of extracapsular dissection (ECD) for BNs, and it aimed to examine the incidence of postoperative complications after parotid surgery for BN. METHODS We collected data obtained in a prospective study of parotidectomy for BN at a university hospital and analyzed the transient and long-term complications. RESULTS The incidence rates of transient facial palsy immediately and 18 months after surgery were 15.0% and 3.7%, respectively. The rates of immediate postoperative facial palsy in patients who underwent ECD, partial superficial, superficial, and total parotidectomy were 5.8%, 29.3%, 20.0%, and 44.1%, respectively. Significant risk factors for facial palsy included multiple and larger lesions as well as surgery duration and extension. CONCLUSIONS Postoperative facial palsy remains a common complication after parotidectomy for BN and is associated with the extent of parotidectomy, presence of multiple neoplasms, and operative duration. The results of this study showed that ECD could be a safe technique for avoiding facial palsy. Level of Evidence: 2.
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Affiliation(s)
- Rubens Thölken
- Department of Otorhinolaryngology and Head and Neck SurgeryUniversity Hospital AugsburgAugsburgGermany
| | - Monika Jering
- Department of Otorhinolaryngology and Head and Neck SurgeryUniversity Hospital AugsburgAugsburgGermany
| | - Marcel Mayer
- Department of Otorhinolaryngology and Head and Neck SurgeryUniversity Hospital AugsburgAugsburgGermany
| | - Stefan Schiele
- Institute of Mathematics, Augsburg UniversityAugsburgGermany
| | - Gernot Müller
- Institute of Mathematics, Augsburg UniversityAugsburgGermany
| | - Johannes Zenk
- Department of Otorhinolaryngology and Head and Neck SurgeryUniversity Hospital AugsburgAugsburgGermany
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Mayer M, Treutlein E, Zenk J, Naumann M, Thoelken R, Jering M. Paraparesis after low dose administration of fluorescein for endoscopic resection of an encephalocele: a case report. Br J Neurosurg 2021:1-4. [PMID: 34755590 DOI: 10.1080/02688697.2021.2001432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/24/2021] [Accepted: 10/22/2021] [Indexed: 10/19/2022]
Abstract
The main causes for cerebrospinal fluid (CSF) leaks are known to be traumatic, iatrogenic, neoplastic, a meningoencephalocele, congenital bone defects, and spontaneous. Off-label intrathecal administration of fluorescein is widely used to localize a CSF leak. Complications are rare and low dose administration is described to be safe. In this case report, we present a case of a patient, who showed a CSF leak due to an encephalocele. Low dose fluorescein was applied intrathecally via lumbar catheter, the CSF leaks could be identified, and multilayered closure was performed. Postoperatively, the patient presented with motor and sensory deficits in the lower limbs which regressed only partially within 2 months. A possible explanation may be an increased local concentration of fluorescein, possibly on the basis of a preexisting lumbar spinal canal stenosis. To our knowledge, this is the first case in which a dose as low as 20 mg of fluorescein (2% saline mixture) led to persisting paraplegia. Therefore, the potential benefits and risks of the intrathecal fluorescein use in the detection of a CSF leak have to be discussed comprehensively prior to surgery.
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Affiliation(s)
- Marcel Mayer
- Department of Otolaryngology, University Hospital Augsburg, Augsburg, Germany
| | - Eric Treutlein
- Department of Otolaryngology, University Hospital Augsburg, Augsburg, Germany
| | - Johannes Zenk
- Department of Otolaryngology, University Hospital Augsburg, Augsburg, Germany
| | - Markus Naumann
- Department of Neurology and Clinical Neurophysiology, University Hospital Augsburg, Augsburg, Germany
| | - Rubens Thoelken
- Department of Otolaryngology, University Hospital Augsburg, Augsburg, Germany
| | - Monika Jering
- Department of Otolaryngology, University Hospital Augsburg, Augsburg, Germany
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Jering M, Zenk J, Thölken R, Rüger H, Psychogios G. Can Ultrasound in Combination with Virtual Touch Imaging Quantification Predict the Dignity of a Parotid Tumor? Ultrasound Med Biol 2021; 47:1192-1203. [PMID: 33541749 DOI: 10.1016/j.ultrasmedbio.2020.12.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 11/20/2020] [Accepted: 12/30/2020] [Indexed: 06/12/2023]
Abstract
Pre-operative evaluation of a parotid gland tumor is crucial in guiding treatment. This study evaluates the diagnostic performance of B-mode ultrasound in combination with Virtual Touch imaging quantification (VTIQ) in the assessment of parotid lesions. A prospective study of 268 patients with parotid lesions was conducted. Pre-operative ultrasound findings and VTIQ data were compared against histologic results. Ill-defined margins on ultrasound were associated with a significantly higher risk of malignancy (odds ratio [OR] = 1224.0, 95 % confidence interval [CI]: 151.8-9872.7). Faster mean shear waves on VTIQ (OR = 1.81, 95% CI: 1.47-2.23, per 1 m/s increase) and an area with shear wave velocity >6.0 m/s involving >70 % of the lesion (OR = 19.80, 95 % CI: 6.22-63.07) were associated with higher risk of malignancy. Addition of VTIQ to routine pre-operative B-mode ultrasound can provide supplemental information on the dignity of a parotid tumor, allowing for peri-operative procedural optimization.
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Affiliation(s)
- Monika Jering
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Augsburg, Augsburg, Germany.
| | - Johannes Zenk
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Rubens Thölken
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Holger Rüger
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Georgios Psychogios
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Augsburg, Augsburg, Germany; Department of Otolaryngology, Head and Neck Surgery, University Hospital of Ioannina, Ioannina, Greece
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Mayer M, Thoelken R, Jering M, Märkl B, Zenk J. Metastases of Cutaneous Squamous Cell Carcinoma Seem to be the Most Frequent Malignancies in the Parotid Gland: A Hospital-Based Study From a Salivary Gland Center. Head Neck Pathol 2021; 15:843-851. [PMID: 33544379 PMCID: PMC8385094 DOI: 10.1007/s12105-021-01294-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/15/2021] [Indexed: 11/27/2022]
Abstract
Malignant parotid tumors account for approximately 20% of all parotid lesions. In addition to the various primary parotid lesions there are secondary parotid malignancies, such as metastases or lymphomas. Data on histopathological distribution of all malignancies-including secondary parotid lesions-is limited. Recent evidence indicated a rising surgical incidence of secondary parotid malignancies. This study aims to review the distribution of malignancies in parotid resections from a salivary gland center. A retrospective review of prospectively collected data for all patients who had received parotidectomy between 2014 and 2019 was performed. Histopathological distribution was displayed separately for all parotid malignancies and for primary parotid malignancies. Further, patients` characteristics were compared between benign and malignant parotid lesions and between the two most common malignant parotid lesions. Out of 777 patients, 614 (78.9%) patients had a benign and 164 (21.1%) patients had a malignant parotid lesion. The most common parotid malignancy was metastatic cutaneous squamous cell carcinoma (cSCC) accounting for 35.4% of all parotid malignancies. 71.5% of all malignant lesions were secondary malignancies. Patients with metastatic cSCC were significantly older (p < 0.001) and significantly more likely to be male (p < 0.001) than patients with primary parotid malignancies. No significant difference was found when the lesion size of metastatic cSCC was compared to primary parotid malignancies (p = 0.216). The present study shows the high prevalence of secondary parotid malignancies in patients who had received parotidectomy. Furthermore, it confirms a rising surgical incidence of metastatic cSCC to the parotid gland in a series from a salivary gland center. At this time, parotid surgery for malignant lesions is more likely to be performed for metastases than for primary parotid malignancies.
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Affiliation(s)
- M Mayer
- Department of Otolaryngology, University Hospital Augsburg, Sauerbruchstraße. 6, 86179, Augsburg, Germany.
| | - R Thoelken
- Department of Otolaryngology, University Hospital Augsburg, Sauerbruchstraße. 6, 86179, Augsburg, Germany
| | - M Jering
- Department of Otolaryngology, University Hospital Augsburg, Sauerbruchstraße. 6, 86179, Augsburg, Germany
| | - B Märkl
- Institute of Pathology and Molecular Diagnostics, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - J Zenk
- Department of Otolaryngology, University Hospital Augsburg, Sauerbruchstraße. 6, 86179, Augsburg, Germany
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Rüger H, Psychogios G, Jering M, Zenk J. Multimodal Ultrasound Including Virtual Touch Imaging Quantification for Differentiating Cervical Lymph Nodes. Ultrasound Med Biol 2020; 46:2677-2682. [PMID: 32651021 DOI: 10.1016/j.ultrasmedbio.2020.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/13/2020] [Accepted: 06/06/2020] [Indexed: 06/11/2023]
Abstract
Defining the entity of cervical lymph nodes (LNs) is essential for the diagnosis and staging of head and neck malignancies. Virtual Touch imaging quantification (VTIQ) is a relatively new method of elastography that measures tissue stiffness quantitatively. A prospective study was conducted that included 108 patients (57 benign and 51 metastatic lymph nodes [MLNs]). Shear wave velocities (SWVs) were analyzed using VTIQ and were compared with the histopathological results. Both maximum and minimum SWVs within the LNs significantly differed between benign masses and MLNs (p < 0.001). Percentage areas of the node with SWVs >6 m/s and <3.5 m/s differed significantly (p < 0.001). Intralesional areas with SWVs ≤3.5 m/s of 0-29% (odds ratio: 93.7) and 30%-69% (odds ratio: 46.3) were predictive of malignant LNs as well as ill-defined tumor (odds ratio: 5.2). VTIQ can provide more information on the entity of cervical LNs.
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Affiliation(s)
- Holger Rüger
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Augsburg, Augsburg, Germany.
| | - Georgios Psychogios
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Augsburg, Augsburg, Germany; Department of Otorhinolaryngology, Head and Neck Surgery, University of Ioannina, Ioannina, Greece
| | - Monika Jering
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Augsburg, Augsburg, Germany
| | - Johannes Zenk
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Augsburg, Augsburg, Germany
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Grosheva M, Klußmann JP, Beutner D, Formanek M, Lill C, Laskawi R, Zenk J, Pick C, Erlacher B, Bemmer J, Thielker J, Jering M, Tostmann R, Guntinas-Lichius O. [Planning and design of European prospective randomized trial on the value of drain in parotidectomy]. Laryngorhinootologie 2020; 100:46-53. [PMID: 32516811 DOI: 10.1055/a-1178-0800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION There are no valid clinical studies on the value of wound drains in parotid surgery. The aim of the current trial is to analyze the influence of the closed wound drain (redon) on the incidence of postoperative complications such as bleeding, wound healing problems, infection, as well as salivary cyst and fistula after superficial or partial parotidectomy. METHODS A European-wide multicenter prospective randomized study was planned. The study protocol was prepared by the leading study center (ENT University Hospital Cologne) in cooperation with the ENT University Hospitals Jena and Göttingen. The calculation of the number of cases was carried out with G*Power. The study includes test persons with an indication for parotidectomy for a benign tumor without known coagulation disorder or ongoing anticoagulation. Preoperative randomization and data management is software-supported (REDCap 9.1.24, Vanderbilt University). RESULTS The study has been approved by the leading ethics committee in 10/2019 and is open since 04/2019. Currently, nine (9) ENT hospitals are participating in the study, 6 of them in Germany and 3 in Austria. Enrollment of patients is ongoing in 7 centers. With a calculated follow-up-to-treat population of 800 test persons, the planned duration of the study is 4 years. CONCLUSIONS The Redon-study is the first prospective randomized study worldwide to investigate the effect of a drain in parotidectomy. In order to achieve the recruitment goal within the planned time frame, the participation of further specialized study centers is needed. We also encourage all ENT physicians to make their patients aware of the Redon study, inform them about the possibility of participating in the study and refer them to one of the participating centers.
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Affiliation(s)
- Maria Grosheva
- HNO Uniklinik Köln, Medizinische Fakultät, University of Cologne, Köln, Germany
| | - Jens Peter Klußmann
- HNO Uniklinik Köln, Medizinische Fakultät, University of Cologne, Köln, Germany
| | - Dirk Beutner
- Klinik für Hals-Nasen-Ohrenheilkunde, Georg-August-Universität Göttingen, Germany
| | - Michael Formanek
- HNO und Phoniatrie, Krankenhaus der Barmherzigen Brüder, Wien, Austria
| | - Claudia Lill
- Institut für Kopf- und Halserkrankungen, Evangelisches Krankenhaus Wien, Austria
| | - Rainer Laskawi
- Klinik für Hals-Nasen-Ohrenheilkunde, Georg-August-Universität Göttingen, Germany
| | - Johannes Zenk
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Augsburg, Germany
| | - Carina Pick
- HNO Uniklinik Köln, Medizinische Fakultät, University of Cologne, Köln, Germany
| | - Birgit Erlacher
- HNO und Phoniatrie, Krankenhaus der Barmherzigen Brüder, Wien, Austria
| | - Julian Bemmer
- Klinik für Hals-Nasen-Ohrenheilkunde, Georg-August-Universität Göttingen, Germany
| | - Jovanna Thielker
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Germany
| | - Monika Jering
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Augsburg, Germany
| | - Ralf Tostmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Georg-August-Universität Göttingen, Germany
| | - Orlando Guntinas-Lichius
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Jena, Germany
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Psychogios G, Rueger H, Jering M, Tsoures E, Künzel J, Zenk J. Ultrasound can help to indirectly predict contact of parotid tumors to the facial nerve, correct intraglandular localization, and appropriate surgical technique. Head Neck 2019; 41:3211-3218. [DOI: 10.1002/hed.25811] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 02/06/2019] [Accepted: 05/13/2019] [Indexed: 11/12/2022] Open
Affiliation(s)
- Georgios Psychogios
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Augsburg Augsburg Germany
| | - Holger Rueger
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Augsburg Augsburg Germany
| | - Monika Jering
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Augsburg Augsburg Germany
| | - Eleni Tsoures
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Augsburg Augsburg Germany
| | - Julian Künzel
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Mainz Mainz Germany
| | - Johannes Zenk
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Augsburg Augsburg Germany
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Psychogios G, Jering M, Zenk J. Cervical Hyperostosis Leading to Dyspnea, Aspiration and Dysphagia: Strategies to Improve Patient Management. Front Surg 2018; 5:33. [PMID: 29740589 PMCID: PMC5928235 DOI: 10.3389/fsurg.2018.00033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 04/09/2018] [Indexed: 12/21/2022] Open
Abstract
Diffuse idiopathic skeletal hyperostosis (DISH) is a rare but well known cause of dysphagia. In very few cases aspiration and dyspnea are described as a clinical manifestation. An 82-year-old man presented himself in our clinic with severe dyspnea, aspiration, and pneumonia. After performing a microlaryngoscopy an emergency tracheotomy became necessary. In laryngoscopy a severe bulging of the posterior oropharyngeal and hypopharyngeal wall was detected. The glottis area was not observable and immobilisation of the right vocal cord could be detected. The CT showed anterior osteophytes and ossification of the anterior longitudinal ligament from C2-C7. We performed a panendoscopy in order to explore the upper aerodigestive area. Postoperatively an emergency tracheotomy was needed due to the development of laryngeal edema. The osteophytes were removed in cooperation with the department of orthopaedics. Three months postoperative the patient had no dyspnea or dysphagia, so the tracheotomy could be closed. Cervical hyperostosis is commonly described in elderly patients and usually presenting without symptoms, therefore a surgical treatment is usually not necessary. Nevertheless it can lead to severe morbidity and dyspnea with airway obstruction. Therefore it is essential that cervical hyperostosis is recognized early enough and appropriate treatment is initiated. Flexible endoscopy should be preferred over direct panendoscopy because it could lead to life-threatening edema and a prophylactic tracheostomy should be strongly considered in patients that present with severe dyspnea.
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Affiliation(s)
- Georgios Psychogios
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum Augsburg, Augsburg, Germany
| | - Monika Jering
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum Augsburg, Augsburg, Germany
| | - Johannes Zenk
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum Augsburg, Augsburg, Germany
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